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Summary

Physical activity and exercise in cardiovascular disease prevention and rehabilitation

A sedentary lifestyle is prevalent in modern society and is an established major modifiable risk factor for cardiovascular disease (CVD). For persons without clinical CVD, amounts of occupational and leisure-time physical activity, as well as cardiorespiratory fitness, are inversely related to CVD risk. For patients with established CVD, observational and randomized trial data consistently demonstrate a lower risk in more physically active individuals. An acute bout of exercise transiently increases the risk of a cardiovascular event, but the absolute risk is very small. The data are consistent with the concept that the greater the total energy expenditure in physical activity, the lower the CVD risk. Potential mechanisms responsible for the cardio-protective action of habitual exercise are not fully understood, but include improvement in classic coronary risk factors, reduction in autonomic nervous system and endothelial cell dysfunction, decreased thrombosis, reduced atherosclerosis progression, and a reduction in myocardial ischemia.